Investigation of Risk Factors for Vancomycin-Resistant Enterococci(VRE) Infection and Colonization

Park, Jin Hee; Lee, Soo Youn; Lee, Mi Ae; Chung, Wha Soon

Abstract

BACKGROUND: The emergence of vancomycin-resistant enterococci(VRE) is increasingly serious problem throughout the world and is likely to increase in Korea. However, a few epidemiologic studies and risk factors of VRE infection have been reported in Korea. We investigated risk factors for VRE infection and colonization.
METHODS
We analyzed 48 patients with VRE(24 infection, 24 fecal colonization) and 62 vancomycin-sensitive enterococci(VSE) in Ewha Womans university hospital from January 1997 to December 1998 and we performed case-control study to assess the risk factors for VRE.
RESULTS
The incidence of VRE infection was 7.3% of all enterococcal isolates and the incidence of VRE colonization from surveillance cultures was increased 0.1% to 1.5% from 1997 to 1998. Compared with patients with VSE, patients with VRE had significantly longer hospital stays. They also had more frequent stays in intensive care unit(ICU) and oncology wards. They had more frequent invasive procedures such as central lines, urinary catheters, nasogastric tubes, ventilators and were more likely to have received vancomycin or teicoplanin or aztreonam or aminoglycosides or cephalosporins therapy(P<0.05). Compared with the patients infected with VRE, the patients colonized with VRE had significantly more frequent stays in the ICU(P <0.05).
CONCLUSIONS
To prevent the VRE infection and colonization, appropriate antibiotic therapy according to the guidelines and cautious handling of medical devices may be necessary.